Provider Demographics
NPI:1609853480
Name:REDDY, ATIGADDA (MD)
Entity Type:Individual
Prefix:
First Name:ATIGADDA
Middle Name:
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10619 PROFESSIONAL CIR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5831
Mailing Address - Country:US
Mailing Address - Phone:775-852-4848
Mailing Address - Fax:775-850-5763
Practice Address - Street 1:10619 PROFESSIONAL CIR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5831
Practice Address - Country:US
Practice Address - Phone:775-852-4848
Practice Address - Fax:775-850-5763
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3738207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2016705Medicaid
NV2016705Medicaid
NVV10WCGZB09Medicare PIN